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EKG Rhythm
 Quiz 1 – Rhythm Recognition




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EKG           EKG           EKG           EKG           EKG
Rhythm 1      Rhythm 1      Rhythm 1      Rhythm 1      Rhythm 1
Recognition   Recognition   Recognition   Recognition   Recognition




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  $400          $400          $400          $400         $400


  $500          $500          $500          $500         $500
Your patient’s HR is 60
    beats/min. The rhythm is
  regular with one “P” wave for
  each “QRS.” PR interval is .18
  and QRS width is .10. What is
     your patient’s rhythm?

Return to Main Board      Answer
Normal Sinus Rhythm



             Return to Main Board
What does a QRS >0.10
            denote?



Return to Main Board   Answer
Bundle Branch Block



              Return to Main Board
This rhythm may be regular or
     irregular depending on
 conduction ratio. Hallmark sign
     is a pattern of multiple
  “sawtooth” p waves to each
               QRS.

Return to Main Board     Answer
Atrial Flutter



            Return to Main Board
An atrioventricular rhythm in
       which the PR interval
   progressively lengthens until
          QRS is dropped.


Return to Main Board      Answer
2* AVB Type 1
     aka
 Wenckebach


           Return to Main Board
A shockable rhythm with no
     well defined QRS. Totally
  disorganized electrical activity
   which may be fine or coarse.
   Never presents with a pulse.

Return to Main Board       Answer
Ventricular Fibrillation



                 Return to Main Board
Regular rhythm. Normal
   QRS. One p wave per QRS.
      PR interval > 0.20


Return to Main Board   Answer
First Degree AV Block
       (1* AVB)



               Return to Main Board
Ventricular rhythm. Wide
 complex QRS. Heart rate 30-40.



Return to Main Board    Answer
Idioventricular Rhythm
         (IVR)



               Return to Main Board
Early escape beat. Wide
   complex QRS. QRS unlike the
     rest of patient’s rhythm.



Return to Main Board    Answer
Premature Ventricular
    Contraction
       (PVC)


               Return to Main Board
Rhythm charcaterized by a
    total absence of ventricular
              activity.



Return to Main Board       Answer
Asystole



           Return to Main Board
This rhythm originates from
       the SA node. Is slightly
     irregular fluctuating with
       patient’s respirations.


Return to Main Board      Answer
Sinus Arryhthmia



            Return to Main Board
Irregular R-R interval. Atrial
       rate >350. P wave not
            discernible.



Return to Main Board        Answer
Atrial Fibrillation



               Return to Main Board
Originates from SA node.
   Regular ventricular and atrial
     rhythm. Heart rate < 60.



Return to Main Board       Answer
Sinus Bradycardia



             Return to Main Board
Early “P” wave followed by
      narrow complex QRS. PR
           interval normal.



Return to Main Board      Answer
Premature Atrial
  Contraction
    (PAC)


            Return to Main Board
Wide complex rhythm
 originating from the ventricles.
  Rate 140 – 200. Can present
     with or without a pulse.


Return to Main Board      Answer
Ventricular Tachycardia



                Return to Main Board
AV nodal rhythm. Narrow
 complex. PR <0.12. P wave may
  be inverted and/or seen after
       the QRS. Regular R-R
            HR 40-60

Return to Main Board    Answer
Junctional Rhythm



             Return to Main Board
Spikes precede atrial and/or
      ventricular beats.



Return to Main Board   Answer
Pacemaker Rhythm



            Return to Main Board
AV nodal rhythm. Narrow
 complex. PR <0.12. P wave may
  be inverted and/or seen after
       the QRS. Regular R-R
            HR 60-140

Return to Main Board    Answer
Accelerated Junctional
       Rhythm
          or
Junctional Tachycardia


               Return to Main Board
Regular R-R. P waves march
     out. QRS may be wide or
              narrow.
       More Ps than QRSs.


Return to Main Board     Answer
Second Degree AV Block
        Type II
          or
       Mobitz II


               Return to Main Board
Normal QRS and PR interval.
   Regular ventricular and atrial
             rhythm.
             HR >100


Return to Main Board       Answer
Sinus Tachycardia



             Return to Main Board
Originates from Atrium. Unable
  to measure PR interval. QRS
   normal. Regular atrial and
       ventricular rhythm.
           HR 150-250

Return to Main Board    Answer
Atrial Tachycardia



              Return to Main Board
Early beat originating from the
 AV node. PR interval <0.12. Or
     no P wave before QRS.



Return to Main Board     Answer
Premature Junctional
    Contraction



              Return to Main Board
Organized rhythm on the
      monitor with no palpable
               pulse.



Return to Main Board      Answer
Pulseless Electrical Activity
           (PEA)



                   Return to Main Board
Ventricular rhythm. Wide
          complex QRS.
       Heart rate 60-100.


Return to Main Board   Answer
Accelerated Idioventricular
         Rhythm



                  Return to Main Board
SA node ceases to pace. An
  automaticity focus escapes to
  become the permanent pacer
  maintaining patient’s inherent
              rate.

Return to Main Board     Answer
Sinus Arrest



          Return to Main Board
Total block of conduction to
 the ventricles. P waves have no
 relationship to QRS. Ventricular
         rate usually < 40.


Return to Main Board      Answer
Complete Heart Block
     (3* AVB)



              Return to Main Board
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